ΔD-二聚体与肺栓塞发生事件的相关性  

Relationship between the change of D-dimer and pulmonary embolism

作　　者：骆艳妮[1] 王岗[1] 王小闯[1] 李佳媚[1] 张静静[1] 侯彦丽[1] LUO Yanni;WANG Gang;WANG Xiaochuang;LI Jiamei;ZHANG Jingjing;HOU Yanli(Department of Critical Care Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院重症医学科,陕西西安710004

出　　处：《西部医学》2021年第4期517-520,共4页Medical Journal of West China

基　　金：国家自然科学基金(81670049,81770057);陕西省重点研发计划(2017SF-059)。

摘　　要：目的探讨患者ΔD-二聚体升高与肺栓塞(PE)的相关性。方法采用回顾性病例对照研究,共纳入我院2017年6月~2018年7月行肺动脉血管造影检查(CTPA)的260例患者为研究对象,纳入患者均行CTPA,并且在CTPA前1周内行两次D-二聚体监测(两次间隔时间>1 d)。根据ΔD-二聚体结果分为ΔD-二聚体>0组与ΔD-二聚体≤0组。采用单因素及多因素Logistic回归模型分析ΔD-二聚体升高对PE发生的可能性。结果本研究共收集ΔD-二聚体>0组150例与ΔD-二聚体≤0组110例;ΔD-二聚体在肺栓塞组的中位数为2960,在非肺栓塞组为5,差异有统计学意义(P<0.001);ΔD-二聚体>0组在PE中占41.3%,ΔD-二聚体≤0组在PE中占20.0%,差异有统计学意义(P<0.001)。单因素Logistic回归分析显示:ΔD-二聚体>0发生PE的可能性是ΔD-二聚体≤0的2.755倍;多因素Logistic回归分析显示:ΔD-二聚体>0组发生PE的可能性是ΔD-二聚体≤0组的2.829倍。在非肿瘤患者中,ΔD-二聚体>0发生PE的可能性是ΔD-二聚体≤0的3.038倍;多因素Logistic回归显示:ΔD-二聚体>0组发生PE的风险是ΔD-二聚体≤0组的2.870倍,差异亦有统计学意义(P<0.05)。结论ΔD-二聚体>0与PE之间有较高的相关性,关注D-二聚体变化可提高PE的早期诊断率,尤其在非肿瘤患者中更显著。Objective To investigate the correlation between elevatedΔD dimer and pulmonary embolism(PE).Methods 260 cases were included in the Second Affiliated Hospital of Xi'an Jiaotong University from June 2017 to July 2018 for pulmonary angiography(CTPA)to determine whether they were pulmonary embolism.Before the examination,260 cases had been tested for D-dimer twice.According to the results of whether or notΔD-dimer increased,they were divided intoΔD-dimer>0 group andΔD-dimer≤0 group.Logistic regression models were used to analyze the possibility of the occurrence of pulmonary embolism.Results In this study,150 patients in the group ofΔD-dimer>0 and 110 patients in the group ofΔD-dimer≤0 were collected;The median ofΔD-dimer was 2960(15,6660)in pulmonary embolism group and 5(1000,1327.5)in non-pulmonary embolism group(P<0.001).41.3%patients in the group of pulmonary embolism hadΔD-dimer>0,20.0%in the group of pulmonary embolism hadΔD-dimer≤0,the difference was statistically significant(P<0.001).Univariate logistic regression analysis showed that the possibility of delta D-dimer>0 in pulmonary embolism is 2.755 times than the delta D-dimer<0(OR=2.755,95%CI:1.559-4.867);Multivariate logistic regression analysis showed that the possibility ofΔD-dimer>0 in pulmonary embolism is 2.829 times than theΔD-dimer≤0(OR=2.829,95%CI:1.533-5.221).In non-tumor patients,the risk of pulmonary embolism was 3.038 times(OR=3.03895%CI:1.569-5.884)whenΔD-dimer>0;multivariate logistic regression showed that the risk of pulmonary embolism was 2.870 times(OR=2.87095%CI:1.414-5.825)whenΔD-dimer>0.Conclusion There is a high correlation between the changes of D-dimer and pulmonary embolism.Paying attention to the changes of D-dimer promotes our attention to pulmonary embolism and improves the early detection rate of pulmonary embolism.It is more significant in non-tumor patients.

关 键 词：ΔD-二聚体 肺栓塞 肺动脉血管造影 相关性 

分 类 号：R563.5[医药卫生—呼吸系统]